okay, this could be a stupid question/story, but my degree is not in nursing - i start this summer
so, when i was in the hospital after a c-section (with my 2nd child) and my son was in NICU - i was prescribed to lortabs (2 every four hours). since i was staying in the hospital, i didn't have to go out and get a prescription - the nurse brought it to me...while i was there.
when i had my first child, i was released from the hospital the next day after my c-section - went to the pharmacy, and took MAYBE 5 or 6 pills once i was home. the rest stayed in my med. cabinet.
but with my 2nd child being in NICU and me being stuck at the hospital without being able to breastfeed, hold him, and do all the things new mothers usually do - i was a nervous wreck and stir crazy - wanting to walk to see him, wanting to walk to the ice machine, wanting to put on make up, wanting to go develop pictures - wanting to do ANYTHING besides sit in the hospital bed without my baby!
point being - since i was doing so much running around, i actually needed the pain meds this time. so, after about 6-7 hours without, i asked the nurse if i could have some and she was nice and brought them to me. i suspected that she'd bring me some 4-5 hours later. when she didn't, i asked again. she brought them to me. i asked if they could just bring them to me when they had the chance (around the time i was prescribed) because i would be needing them and i didn't want to bother them - and she said no, and that i had to ask for them. i felt like a drug addict begging for meds every 4-5 hours! i hated it. and after a few times of asking, i felt like THEY were treating me like one!
why do you have to ASK for pain meds in the hospital when they're prescribed after surgery? i'm sure there's a reason - it just made no sense at the time.
Let me say that I'm sorry you had a bad experience with pain control during your hospital stay. I know that pain control is one of those things that can put a negative light on the care a patient receives, even if everything else is superb.
(Not a nurse yet) but I think if I had a patient with your situation I would have done the assessments, and I probably would of brought the meds with me in my pocket assuming that you'd need them. As long as you didn't start showing any signs or symptoms of over sedation or overdose, I would of keep giving you the meds.
If you started to show signs of having too much pain medication in your system I would have told you what those sings were and explained to you why I think giving you pain medication would be dangerous at this time.
I think communication can help a lot in these kind of situations.
Just continuing on the same thoughts of "if you were my patient" I think I would of asked for some prn anxiety meds. Did you get any anxiety meds? The things you described, pacing the halls, putting on make-up during an inappropriate time, having a child in the NICU, all scream anxiety to me. The funny thing about anxiety though is that anxious people almost ALWAYS quip back "Me anxious?!" For some reason anxious scoff at the suggestion their anxious, but I've learned that if you rephrase the question more colloquially they're is less of a stigma attached. Like "Do you feel like your nerves are shot?" "Is your mind racing a million miles an hour?"
no, i wasn't on any anxiety medication. i think because my husband was there with me the whole time, it was probably assumed (and rightfully so - sorta) that if anything was wrong, they'd be alerted. i can see how a patient who is alone is monitored more closely than someone who is not.
anxiety is a possibility. when i went for my post natal check-up the doctor prescribed me Paxil (i think) or some popular med - i can't even remember the name. i didn't get it filled because i don't even like taking medicine and didn't want it to become my normal.
i don't know that putting on make-up was "inappropriate." i'd think it might be inappropriate for a new mother to be asking for her i-pod or wanting to paint her nails (or put on make up) if her newborn was there with her post-op, or post vag for that matter. when you're brought a polaroid and sitting around doing NOTHING why not put on some make up so when you can finally take pics, you look alive? lol. it's not like you have a child to care for. my first pic is with me/my husband in NICU and our son has wires coming out of his head/feet and everwhere you can imagine. that was one of those "inappropriate" things i was doing - going to the hospital lobby to post pictures the staff gave me on a CD to my "myspace" account because nobody could visit him. i guess since i had make up on and went the lobby on got on the evil social network, i was fine and dandy!
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I really don't think a c-section patient on the first day needs to be observed for signs of addiction in the absence of a history where tolerance and withdrawal symptoms make it necessary to manage that in addition to the surgery. It wouldn't occur to me to attempt to space out pain meds on the first day post op when the patient is already on oral pain meds. Maybe I'm missing something here. Where I am most c-section patients are booted out sooner than they should be imo, so you wouldn't have time to accomplish such an intervention even if you did think it was indicated.
I really don't think a c-section patient on the first day needs to be observed for signs of addiction in the absence of a history where tolerance and withdrawal symptoms make it necessary to manage that in addition to the surgery. It wouldn't occur to me to attempt to space out pain meds on the first day post op when the patient is already on oral pain meds. Maybe I'm missing something here. Where I am most c-section patients are booted out sooner than they should be imo, so you wouldn't have time to accomplish such an intervention even if you did think it was indicated.
what do you mean when the patient is already on oral pain meds? oral pain meds is what i have been talking about (tablets).
However a sleeping person isn't aware of their pain. No more so than any other unconscious patient.
Sort of a "If a tree falls in the woods and nobody's there to hear it, does it still make a sound?" theory. (It still makes a sound).
I don't think the California BON would say that sleeping patients can still experience pain if there wasn't some reason to believe it's true.
Trust me from personal experience, you can still be aware of your pain while asleep. Also, the effects of pain that need to be treated are not just in the "awareness" of the pain.
If I stabbed someone who is asleep, would they not wake because they aren't "aware" of the pain?
Specializes in Peds/outpatient FP,derm,allergy/private duty.
what do you mean when the patient is already on oral pain meds? oral pain meds is what i have been talking about (tablets).
i'm confused.
I probably shouldn't have used the word "already", but the meds with the most rapid onset are usually used first, given via your IV, second as an intramuscular injection, and third as an oral medication. That would be the general sequence, with variations depending on each doctor's routine.
CNA in ADN However a sleeping person isn't aware of their pain. No more so than any other unconscious patient.
But a sleeping person isn't an unconscious person. And sleep goes through cycles of awareness wherein someone could be having a physiological response to the pain just below their awareness as evidenced by guarding, grimacing and restlessness.
Specializes in Nurse Leader specializing in Labor & Delivery.
In most cases, vag deliveries where I work are discharged 24 hours post delivery and c/s deliveries are discharged 48 hours post delivery.
Where I work, a C/S can stay for 3 midnights, and if she has a baby in the NICU, she automatically would stay the entire time before going to boarder status.
Specializes in Nurse Leader specializing in Labor & Delivery.
However a sleeping person isn't aware of their pain. No more so than any other unconscious patient.
So not true. Not only that, but as soon as they wake up, then they will be in excruciating pain because they were asleep, and if the nurse didn't wake them to give meds, they may not have taken anything for 6+ hours.
If my patient requests that I do so, I absolutely WILL wake a pt q4h to give them pain meds after abdominal surgery. Staying on top of the pain is SO much better than trying to play catchup.
However a sleeping person isn't aware of their pain. No more so than any other unconscious patient.
I hope you're not going around perpetuating this nonsense. I think maybe you need to review some neuro physiology and the all-important GCS. Many "unconscious" patients can be in excruciating pain but be physiologically unable to wake up so can't be compared to "sleeping." Equally, an asleep patient could be in a med induced stupor or just simply be sleeping heavily and wake up to unbearable pain which would be a heck of a lot harder to control had you dealt with your patient's pain appropriately.
because it is a prn med, meaning the patient needs to ask for it. if my patient needs it every 4 hours, i will call the md and have the order change to a standing order. problem solved!
not only that, but the the prescriber is cued in on the situation by the nurses request for a change to a standing order. maybe something is going on that the prescriber needs to know about.
Specializes in Nurse Leader specializing in Labor & Delivery.
Not only that, but the the prescriber is cued in on the situation by the nurses request for a change to a standing order. Maybe something is going on that the prescriber needs to know about.
It's obvious who the people are in this thread that really don't have experience with mother/baby nursing.
It's totally appropriate and normal for a fresh C/S to need pain relief q4h, especially if she is ambulating a lot (as was the OP). That does NOT mean that it's appropriate or necessary to get a new order for an ordered dose of medication. This is a person who will feel significantly better in 24 hours, and why get the order changed (which is being given within the parameters ordered), only to get it changed again the following day when she no longer needs q4h pain management?
If I called a doctor and said "Hey, my pt who just had a C/S this morning needs pain meds every 4 hours, maybe there's something wrong" they would look at me like I was crazy, and then they might either laugh, or get annoyed at my stupidity.
Now if the medication, given as ordered, is not offering pain management, then it would be appropriate to get a new order for something else/additional.
backatit2
368 Posts
no, i wasn't on any anxiety medication. i think because my husband was there with me the whole time, it was probably assumed (and rightfully so - sorta) that if anything was wrong, they'd be alerted. i can see how a patient who is alone is monitored more closely than someone who is not.
anxiety is a possibility. when i went for my post natal check-up the doctor prescribed me Paxil (i think) or some popular med - i can't even remember the name. i didn't get it filled because i don't even like taking medicine and didn't want it to become my normal.
i don't know that putting on make-up was "inappropriate." i'd think it might be inappropriate for a new mother to be asking for her i-pod or wanting to paint her nails (or put on make up) if her newborn was there with her post-op, or post vag for that matter. when you're brought a polaroid and sitting around doing NOTHING why not put on some make up so when you can finally take pics, you look alive? lol. it's not like you have a child to care for. my first pic is with me/my husband in NICU and our son has wires coming out of his head/feet and everwhere you can imagine. that was one of those "inappropriate" things i was doing - going to the hospital lobby to post pictures the staff gave me on a CD to my "myspace" account because nobody could visit him. i guess since i had make up on and went the lobby on got on the evil social network, i was fine and dandy!